Over the past two decades, global health has focused on individual diseases. Surgical care has been afforded low priority in the world’s poorest regions – leaving five billion people without access to safe, affordable surgical and anesthesiology care. Patients requiring surgical treatment will face multiple hurdles: 1) Delay in seeking care, 2) Delay in reaching care, and 3) Delay in receiving care. Reaching the hospital does not guarantee as many hospitals lack the proper infrastructure to provide emergency surgical care. As a result many easily treatable conditions become diseases with high fatality rates. As many as 90% of maternal deaths could be averted by timely intervention. For those who successfully obtain treatment, one in four will experience financial catastrophe as a result of receiving surgical care. To save lives and prevent disability, an additional 143 million surgical procedures are required annually in developing countries. Today’s surgical workforce would need to double in fifteen years to reach our target of 80% coverage of timely access to essential services by 2030. The total costs to reach these targets are significant at approximately 350 billion dollars by 2030. However, the costs of failure are even greater. The lost output will cost developing countries an estimated 12.3 trillion dollars. Investing in surgical care is affordable, saves lives, and promotes economic growth making surgery an indivisible, indispensable part of health care. This research study will explore various areas throughout the globe that are in need of improvement in the area of surgical care and provide a comprehensive outlook as to what the areas of problem are.
Process:
Phase 1: Global Health
I utilized “Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development” which was published by the Lancet Global Health Institute in August of 2015 as the basis for my research. This 56-page publication is filled with various statistics, graphs, charts, and raw data. After understanding the content of the article thoroughly, I decided that it would be best if I initially provided a summary of the article itself so as to provide the foundational basis necessary for the rest of this research study. Following that, I chose to showcase my original analysis by taking the information given in the various charts and table and organizing them into more meaningful representations, upon which I drew conclusions.
Phase 2: Global Surgery
The Global Indicator Initiative gathered information on six indicators for each of the 215 countries or independent economies that are kept by the World Bank. These indicators assess:
1. The geographic accessibility of surgical facilities
2. The density of specialist surgical providers
3. The number of surgical procedures provided by 100,000 population
4. Perioperative mortality rates
5. The risk of impoverishing expenditure when surgery is required, and
6. The risk of catastrophic expenditure when surgery is required
Purpose:
Phase 2: Global Surgery
The Global Indicator Initiative gathered information on six indicators for each of the 215 countries or independent economies that are kept by the World Bank. These indicators assess:
1. The geographic accessibility of surgical facilities
2. The density of specialist surgical providers
3. The number of surgical procedures provided by 100,000 population
4. Perioperative mortality rates
5. The risk of impoverishing expenditure when surgery is required, and
6. The risk of catastrophic expenditure when surgery is required
Originally displayed in a standard excel sheet, I converted the information into various graphs and charts and analyzed for common trends and patterns. By looking at various factors such as income, total GDP, and level of development, clear commonalities arose from which I was able to draw conclusions.
Purpose:
The purpose of this research study is to explore the remarkable gains that have been made in global health in the past 25 years. However, this progress has unfortunately not been uniform. Mortality and morbidity from common conditions needing surgery have grown in the world’s poorest regions, both in real terms and relative to other health gains. At the same time, development of safe, essential, life saving surgical and anesthesia care in low-income and middle-income countries have stagnated or regressed. In the absence of surgical care, case-fatality rates are high for common, easily treatable conditions including appendicitis, hernia, fractures, obstructed labor, congenital anomalies, and breast and cervical cancer. By better understanding the characteristics that are found amongst all developing countries, perhaps a plan regarding future development can be created that will be effective in resolving these issues within the next fifteen years. I will also analyze six different indicators including access to timely essential surgery, specialist surgical workforce density, surgical volume, perioperative mortality rate, risk of impoverishing expenditure for surgical care, and risk of catastrophic expenditure for surgical care. The analysis of this date can be used to inform the policy decisions of governments looking to strengthen health systems through an up scaling of surgical care and offer a baseline upon which governments can measure improvements during the era of Sustainable Developmental Goals.
To view my final report, click here.
